中央型结直肠癌肝脏转移瘤同期手术治疗分析

Simultaneous Liver and Colorectal Resection for Synchronous Central Colorectal Liver Metastasis:A Report of 23 Cases

目的:探讨中央型结直肠癌肝脏转移瘤同期手术的可行性及疗效。方法:回顾并分析了中国医学科学院肿瘤医院从1995年1月至2010年12月间23例同期中央型结直肠癌肝脏转移瘤同期手术的患者,分析疗效。结果:男性16例,女性7例,年龄34～68岁,无手术死亡病例。手术时间(306±7.2)min,术中出血(421±12.6)ml。术中输血者6例,住院天数(11.4±1.8)天。手术并发症:胸腔积液4例,胆漏1例,下肢静脉血栓1例。均治愈。术后随访至2010年12月。1、3、5年生存率分别为:74.0%,48.5%,17.00%。术后1周内肝功能均恢复至ChildA级。结论:选择性肝区域血流适时阻断配合超声乳化吸引刀同期行中央型结直肠癌肝转移瘤切除术比较安全可行,疗效较满意。

Objective： To investigate the feasibility and long term outcome of simultaneous liver and colorectal resection for cen- tral synchronous colorectal liver metastasis. Methods： A totoal 23 colorectal liver metastasis patients, who underwent simultaneous colorectomy and hepatectomy between January 1995 and December 2010 in the Cancer Hospital, Chinese Academy of Medical Science, were retrospectively analyzed. Results： The group included 16 males and 7 females, with age ranging from 34 years to 68 years. No deaths occurred within the 30 days after surgery. The overall median operative duration was 306 ＋ 72 minutes, intraoperative bleeding was 421 ~ 126 mL, and the median hospital stay was 11.4 ~ 1.8 days. Six cases received blood transfusion, 4 had pleural effusion, 1 had bile leakage, and 1 had thrombus of the lower limb. The 1-, 3-, and 5-year survival rates were 74.0%, 48.5%, and 17.0%, respectively. All liver functions recovered to Child A within 1 week. Conclusion： Simultaneous liver and colorectal resections are safe and effective for synchronous central colorectal liver metastasis.